Managing Stomach Issues from NSAID's

Yes, I know it's not ideal to take more Advil than recommended, but the pain I have is bad enough that I'd go to the ER, except that my useless former PM will tell them not to do anything at all to help me (I'm pretty angry about that). My PCP & neurologist are both trying to get me into a new pain clinic ASAP, but I just spoke with the people at the Rush clinic yesterday & was told it will likely be mid-February before they can fit me in. So, I'm stuck taking a very high quantity of Advil just to get the pain low enough that I can get any sleep at all, can bathe & can sit up to watch TV, all still with a lot of pain.

Unfortunately, my stomach is not so keen on Advil. I get horrible stomach cramps, diarrhea 1-2x/day & occasional vomiting. My PCP is managing the vomiting (thank goodness!), but mostly she just says she feels so badly that she doesn't know how to help me & she can't believe my former PM just pulled me off all meds with no warning when I was doing well & taking them as prescribed. My psychiatrist had said she was going to help me, but since has changed her mind. All she does is talk about how she needs to keep upping my Seroquel because I seem to be very angry all the time (well, if your right leg felt like it was being crushed & frozen to death at the same time, how content would you be?!). She said maybe she'll consider doing something to help the pain in May.

Has anyone gone through this? Was there anything that helped? I've tried upping fiber intake. It doesn't help. I really don't want to be taking all this Advil, but until I can get a new PM, there isn't any alternative available to me. I'm allergic to lidocaine patches. I use Icy Hot. I tried TENS. I'm seeing a pain psychologist. Very hot baths help in the short term so I can sleep a bit, but I suspect they may be making the inflammation worse in the mid-term. I'm too nervous to try kratom.

Psych said the acute withdrawal period from fentanyl is 6 months -- Nov-May. It's already been over 30 days & I'm still having a lot of GI symptoms even before I started taking Advil so I could get out of bed. Any symptom at all I complain about, my psych attributes to "withdrawal". I was running a 102F fever at 21 days after discontinuing meds & she said that was withdrawal; turned out it was a bad virus that I caught from my infant nephew. Everyone in my family caught it.

I think she is totally clueless. She also said that tapering was totally unnecessary & that I shouldn't need anything other than Pedialyte for withdrawal symptoms. She's an idiot, but at least she gives me Seroquel to help a little with the sleep. Wait list for psychiatrists in my area is 6-7 months. When I went with her, it was because her wait list was the shortest at 5 months.

I'm not looking for any opioids. Trump has said he wants the FDA to cut production limits by 95%, so I figure most people in chronic pain will soon no longer be able to find any pharmacies stocking them. My neurologist recommended IVIG. It sounds very promising. I've been on Celebrex in the past. My former PM refused to write me even for that. Not Neurontin, not Lyrica, not physical therapy, nothing. He just stopped all treatment, but insisted I should still schedule monthly follow-up appointments with him. I have no idea what caused him to do so. I had returned to work from PTSD disability & was doing well, and all the sudden he tells me to reapply for SSDI for pain so I could stay in bed 22 hours a day, rather than taking any meds. When I told him I refused to get an SCS re-implanted (my last 2 -- which he implanted -- had horrible staph & pseudomonas infections that spread the entire length of my back), the only thing he offered was that in March he would write me for low-dose Naltrexone, which he claims could help my pain. His records state that I was using my meds properly, was benefiting from them, and was assessed to be in the lowest category for risk of addiction (only scored 1 point because I was on chronic opioid therapy). He didn't just pull me off opioids; he pulled me off Lyrica & Imitrex. He refused to even prescribe me Catapres patches for withdrawal, even though my blood pressure skyrocketed & I was having 5-7 extra heart beats per day; my PCP tried to reason with him to no avail before referring me elsewhere. He had been my PM for 12 years. I have no idea what changed this year, but he's had probably 12 MA's plus his PA quit this year & my PCP said that all her patients who have him as their PM were complaining about poor quality of care. My neurologist said he thought maybe my PM had a patient who had an adverse reaction to their meds & my PM just didn't take it well. I don't really know, nor does it matter much at the end of the day. I just need to move on to a new clinic ... February just can't come soon enough.

My daughter was just prescribed the anti inflammatory "meloxicam". Her doctor said it would be easier on her stomach. She has IBS and is also on metformin which causes chronic diarrhea. Perhaps this is something that you can ask your doctor about. She also takes Prilosec because of all the other meds that she is on.

I've heard some folks say that they take their meds with milk as it seems to help the stomach lining. Are you taking a probiotic to aide with gut health?

I have found pain relief with homeopathic Arnica.

I had a friend who was given Arnica by an oral surgeon after surgery for a root canal, and she had good pain control.

Arnica has a good reputation among the holistic community. It comes in varied strengths (30 mg up to 200 mg).

Honestly, I read your posts and am in utter disbelieve of the lack of sensitivity being shown to you by your medical providers. What is the benefit of your being in agony?

"How does one ask one to suffer more, when they are already suffering?" - unknown author -

You have my genuine empathy. I wish that I knew how to help you.
- Karen -

Tirzah,

I would not be so quick to dismiss the low dose naltrexone. My doctor started me on LDN, in addition to ketamine infusions, over a year ago. Between the two I was able to get off of all opioids and antidepressants, and I now have FAR better pain control and quality of life than I ever did on opioids or any other medication. You are right that there have been no large double blind clinical trials done on LDN -- only small clinical studies with limited controls have been done -- and it is considered "experimental" for that reason. But there is actually quite a bit of scientific evidence in the primary literature showing that it works as a glial cell inhibitor, resulting in the reduction of inflammatory mediators within the central nervous system (which likely contribute to centrally mediated pain aka "central sensitization" -- often a major component of chronic pain -- among other things).

Yes, the LDN may not work for you, but if you are struggling so much with how things are now, then it may be worth a try. It has a very low side effect profile, and it certainly is a lot less harmful to your liver than massive doses of NSAIDs. Besides my professional medical training, I also also have liver issues myself, so I am VERY aware about how any medication I take is metabolized (in fact I can't even take NSAIDs because of my liver issues). One thing is certain, though, if you continue taking NSAIDs like you are, it is pretty much only a matter of time before you end up with gastric ulcers, or worse, kidney or liver damage (at the very least you should DEFINITELY be taking omeprazole or another gastropreotectant with the ibuprofen).

If you have questions about the LDN, a couple websites my doctor referred me to when I was first considering it are lowdosenaltrexone.org and ldnresearchtrust.org. It's your decision of course, but I will say that my doctor has been using LDN routinely in his patients (mostly CRPS patients, but other pain patients as well) for quite a few years now, and has had very good success with it, as have I, personally. Just something to think about.

Skeye

Post Edited (skeye) : 12/31/2016 2:43:46 PM (GMT-7)

Yeah, that definitely sucks about what your PM did to you. That's no way to treat someone! I had my problems with former PM's, but fortunately none of them did anything like that to me.

And I feel you in regards to not having a diagnosis, too. It took me 9 years to find a good PM, and as long to get a diagnosis (my current PM -- the one that prescribes me the LDN -- is the one who FINALLY diagnosed me with CRPS after all these years).

Is there any way that you could dissolve your contract with your current PM, seeing as he's really not treating you anyway, and have your PCP or someone else take over your care for the couple months it takes to get the appointment with the new PM? It seems ridiculous that he has such a hold over you, given that he isn't doing or prescribing anything.

Also, have you thought about or tried things like acupuncture? I've found acupuncture really helpful in the past for certain things. Unfortunately, it takes repeated visits and is expensive, though.

I also just had knee surgery a few weeks ago & am still having significant trouble with bone/soft tissue pain and nerve pain from the original injury that I sustained 6 mo ago (unfortunately, surgery was unable to fix it & instead has only added to my problems) and my PM suggested trying a copper or magnetic knee sleeve, as there is evidence that both help reduce pain and inflammation (one of the things that I love about my PM is that besides the conventional, he always thinks of things outside the box, too). Unfortunately, I can't try the magnets, as I have a neurostimulator, and the magnets generate too strong of a magnetic field for the proximity that they would be to my stimulator, but I did order a copper sleeve. The brands that my doc recommended are Copper Fit and Tommy Copper. I don't know where the pain is in your leg, but when I had looked at the Tommy Copper website a couple weeks ago, they did make entire leg sleeves, as well as ones that target a specific area, like the knee. I haven't been able to try my sleeve much yet, as my PT has been taping my knee, and I'm afraid that the sleeve would rub the tape off, but I sadly won't have this PT anymore after next week, and I am going to try it then.

There is also a company called Back on Track that makes braces and garments infused with ceramic particles, which reflect infrared radiation and improve circulation and decrease inflammation to the underlying tissues. They actually started by making products for horses, and have done some pretty neat clinical studies in horses, some which is available on their website. I use a few of their products myself (you can feel the warmth they generate, it's pretty neat), and I also use them extensively in my dogs for injury prevention in my competition agility dog, and for therapy in my old dog with crippling arthritis.

Anyways, hope you are able to find something to help! Hang in there!

Skeye

Ugh, that icy feeling sounds awful!

Nope, the BOT products don't get very hot, they will just make you feel a little warm. They essentially reflect your own body heat back at you, but nothing more. They don't get anywhere near as hot as say a heating pad would. The level of heat is kinda like that of your body heat that is trapped under your blankets when you sleep at night.

Hope your neuro is able to help you while you wait for your appointment! I would think/hope that at least one of your doctors would be willing to put you back on the Lyrica, etc, if that was helping before, even if they aren't willing to try anything new!

T
Just read your posts here.
What an awful way to be treated !! So so sorry !
How are you doing ?

Tirzah, somehow I missed that info on Trump. If you still have the info, would you please post the link to it. Thanks.